The Mystery of Prime Numbers

 

The Mystery of Prime numbers.  

Solving the problem of prime numbers is an exceedingly challenging task for mathematicians.

A prime number (or prime) is a natural number greater than 1 that has no positive divisors other than 1 and itself.

Using Euclid’s theorem, there are an infinite number of prime numbers.

A prime number is any number that cannot be expressed as the product of two numbers other than itself and one. 

For example, 15 = 3 x 5, so 15 is not a prime number; and 12 = 6 x 2 = 4 x 3, so 12 is not a prime number. On the other hand, 13 = 13 x 1, and is not the product of any other pair of numbers, so 13 is a prime number.

There is no way for us, even with a university advanced training in pure mathematics can we tell, just by looking at some numbers whether they are prime or not. 

We can tell at once that certain numbers are not prime. Any number, however long, which ends in a 2, 4, 5,6,8 or 0, or whose digits do not add up to a sum divisible by 3, is not a prime. 

But if a number ends in 1,3,7, or 9, and if its digits do not add up to the sum divisible by 3, it may be a prime or may not. There is no formula for us calculate out this. We just have to and see if we can make it by the product of two smaller numbers.

One way of looking for a prime randomly is to begin by entering all the numbers beginning with 2 and going as high as we possibly can, say up to 100,000. The first number is 2, which is prime. Omit that and go up the list by removing every second number. That eliminates all the numbers divisible by two, which are therefore not prime. The smallest number left after 2 is 3. That’s the next prime and, leaving that in place, you just cross out every third number thereafter to get rid of all the numbers divisible by 3. The next untouched number is 5 so you cross off every fifth thereafter. The next is 7, every seventh; then 11, every eleventh; then 13… and so on.

We might ponder that as we keep crossing out more and more numbers, we may ultimately reach a point where all the numbers greater than the same particular number will be crossed out, so there will be no more prime numbers after some particular highest prime number.

Unfortunately, it is not that simple.  It just cannot happen. No matter how high up we go into the millions, billions, perhaps into trillions (I have not tried), there are always more prime numbers higher up that have escaped all the crossing-out.

We already know as long ago as 300 BC., the Greeks mathematician Euclid demonstrated that no matter how high up we go there must be prime numbers higher still.

For instance, if we take the first six prime numbers and multiply them together: 2 x 3 x 5 x 7 x 11 x 13 = 30,030. Now add 1 to get 30031. That number cannot be divided evenly by either 2,3, 5,7, 11, or 13, since in each case we will get a result that will leave a remainder of 1.

If 30,031 can’t be divided by any number except by itself, it is a prime number. If it can, then the numbers of which it is a product must be higher than 13.

In fact, 30,031 = 59 x 509.

We can do this for the first hundred prime numbers or the first trillion, or the first any amount. If we calculate the product and add 1, the final figure is either a prime number itself or the product of the prime number higher than those we’ve included in the list. In other words, it does not matter how far we go , there are still prime numbers higher still, so that the number of prime numbers is infinite.

Occasionally, we may come to pairs of consecutive odd numbers, both of which are prime: 5, 7; 11, 13; 17, 19; 29, 31; 41, 43. As high as mathematicians have searched, such prime pairs are found. Are there an infinite number of such prime pairs? I don’t think we know. Mathematicians think otherwise, but they have never been able to prove this.  

That’s why we are interested in prime numbers. Prime numbers overture simple sounding problems that are very tough to work out and mathematicians can’t resist this challenge.

What use are these prime numbers we may ask? None we admit, except they offer us a huge academic challenge to the greatest of our mathematical minds. 

Perhaps it is easier for us to apply tensor calculus in astrophysics and in theorectical cosmology, areas of studies I am familiar with at Oxford than trying to deal with this mystery on prime numbers! 

Any mathematician wanting to take up this mind-blowing challenge? 

 

 

 

Which would be perferable? Under or Over Nutrition?

 

Which would we choose, under or over nutrition?

Both are technically malnutrition or bad nutrition . Mal means bad. 

I have given this answer in my article:

 “Which is the Most Challenging Field in Medicine and Health Care?”

 here:

https://scientificlogic.blogspot.com/2023/

 

Let me dig out that question and answer again. Before that, let us give ourselves an example of normal distribution curve.

Which would we choose, under or over nutrition since both are classified as bad or malnutrition 

"Mal" means "bad". 

Explaining further, let us give ourselves an example of normal distribution curve.

In a normal distribution curve there is a minmium on both sides, with a peak somewhere in the middle. The peak is the average or the medial where the cluster of the data is highest. Clustering around the medial are the rest of the data with its Standard Deviation at the tail ends of the the distribution curve. 

Assuming this peak represents the optimal nutrition which we may also represent as optimal health.

Anything on the left of the left of the curse is sub-optimal. Let this be undernutrition. 

Anything on the right of this peak is also sub-optimal, representing excessive and overnutrition. 

Anything on either side of this optimal (maximum) peak is either under or over optimal. Since we are unable to define or determine which would be under or over nutrition for an individual, which side of the curve would we choose to advise an individual how much he or she to take at least to get as close as possible to reach the peak of optimal health? Bear in mind all recommended nutrient intake is based on very large population studies who are in apparent good health through food consumption studies, clinical, anthropometric measurements, age, heights and weight, gender, occupation, physical activities, biochemical, social, economic studies, food supply and food balance sheets among other parameters.  Now we are in hot soup between the deep blue sea and the devil. We cannot answer this with certainty since our nutritional needs are so personal and individualized. We can only  rely on Recommended Daily Allowance based on food consumption studies in large population studies.

As a research nutritionist and food scientist I would not be able to give any specific advice to any individual on his specific nutritional requirements because of vast individual variations. 

This is so unlike the practice of medicine where we can prescribe  the exact dosage of a medicine to a patient. This make the practice of medicine far, far easier than the practice of nutrition for sure. The practice of medicine is quite standard plus or minus a little bit, but not in nutrition because of vast biological needs. 

But if you were to force me for an answer, I would choose the deep blue sea of undernutrition for the simple reason I have explained that there are now over 100 studies both in humans and all animals without exception that under nutrition, specifically caloric restriction greatly prolongs life, not just longevity but disease-free long life. 

I have already proposed a few logical theories to explain this. It is up to nutritionists, nutrition scientists,  and other biomedical scientists to accept these hypothesis and use them as a springboard to work on them further. 

Under nutrition in very severe cases only such as marasmus, kwashiorkor, scurvy, night blindness, beriberi, riboflavin deficiency, pellagra, iron deficiencies...etc, etc can easily be corrected within days, but not chronic degenerative diseases such as diabetes, metabolic syndrome, cardiovascular and stroke, renal, liver diseases due to overnutrition. 

So make your choice between the deep blue sea which can be rescued and the devil that is permanently taken away 

Which is the Most Challenging Field in Medicine and Health Care?

 

  

  I received a question from the mother of a doctor in Singapore. She posted her question under this article:

“The Management of Chronic Diseases via Different Therapeutic Modalities with Peptic Ulcer Disease as an Example”

https://scientificlogic.blogspot.com/search?q=the+management+of+peptic+ulcers

Greetings Dr. Lim,

My name is Shanzey, a Malaysian working in Singapore. My daughter and myself have been reading all your articles with great interest especially on health and medicine. My daughter is a doctor here in Singapore who intends to specialize but she is unsure which area would be easiest, and which would be hardest, and which area in medicine can earn her better money. The area should not take too long to study, but more importantly not too tough especially with diagnosis. We solicit your expert advice and thank you in anticipation.

 

My question is:

Which field of medicine is most challenging, time consuming but with better income?

--------------------------------------------

 

Thank you for your question, Shanzey.

You have asked me a very tough question. If your daughter cannot decide, how am I to know? I can’t decide for her. The study or the practice of medicine, like everything else in life, is very personal. All depends on individual taste.

Some like to study a certain field to be an expert on it in their working life, others not.  It all depends on individual taste, interest and aims in life.  affordability, economic and social circumstances and other environmental and influencing issues, outcome and dynamics. There is no one sure answer that suit all.

If your daughter is thinking about earning capacity, I think an area such as cardiac and liver surgery can be very specialized and technically very challenging, besides good income as there are not many doctors around who are good in this area. She may not need any other specialist doctors to help out, except in surgery with teamwork effort from supporting staff such as the anaesthesiologist, perfusionist, haematologist, immunologists and theatre nurses.

But this does not mean other areas in medicine or surgery are less important, less difficult, less in demand with less earning outcome. I should say, all health-care professions are equally important, and all are in demand.

However, if your daughter intends to go into private practice, there are only two areas I strongly would not advise her, or any doctor for that matter.  Never go for emergency medicine and forensic medicine. The reason is obvious. If you are in private practice, who would send an emergency case, say a serious trauma case in the streets or in a shopping mall, or someone who is already dead as in forensic medicine to your private clinic?

A Good Samaritan, say who saw a street accident, or someone with a heart attack in the office, or anywhere, even at home, would straight away call an ambulance to dispatch a casualty to the emergency department of a government or public hospital.

He is not going to send him or her to your private clinic or to a private hospital and pay for it. Neither would any sensible person send a person who is already dead to your private practice. He will send him straight away to a mortuary and call the police. He or she will never send a dead person to your private clinic or to a private hospital and pay the private doctor to “treat” a dead person. He will of course straight away send the body to a government hospital and ask them to deal with it. It is a police case. So don’t touch these two extreme areas in medicine unless your daughter intends to stay in government service where she will be paid whether the patient is dead or alive.  

Emergency medicine, which I am more familiar with, is very dramatic and lifesaving, but in terms of income and earning capacity it is almost zero. A doctor specializing in this area in private practice can wait for all eternity, and not get even one patient sent to him or her. It is the same with forensic medicine. It is a dead medicine. Both are at the extreme ends, one highly dramatic sent to the triage red zone in a public or government hospital, the other on the extreme end, into the black or white zone (mortuary). Never, never go into these two extreme areas of specialization if your daughter is thinking of going into specialized private practice later.

I should say, choose something in between where there is a demand such as general medicine meant for all, or O & G for female doctors, paediatrics for families with young children. General medicine probably is the best because all patients generally go to an ordinary GP or a physician first because patients normally would not know what ailments are troubling them, except some symptoms they suffer. So, they will see their doctor or a GP first as front-line healthcare professionals to have it sorted out. I should say, most cases are medical in nature rather than surgical. Once a general doctor or a GP sort this out, he or she will refer the case to an appropriate specialist who may be anyone from a cardiologist, oncologist, rheumatologist, haematologist, psychiatrist, ENT, cardiac, neuro, orthopedic, eye surgeon all the way down from A to Z in specialty. All are relevant with good income in private practice.

As far as length of study and technical difficulty to your question is concerned, I think all are lengthy and challenging to study and to specialize. It takes at least another 4 years from a basic MBBS or an ordinary MD degree to get a master’s degree in a field of specialization. A general medical doctor will have to study all the basic medical sciences such as anatomy, physiology, biochemistry, pharmacology, bacteriology or microbiology, histology, pathology, cellular biology, genetics and basic molecular biology all over again especially if it was for the UK MRCP or MRCS Part 1 before going into the area of specialization where they need to pass the examinations on these subjects before going to Part II examination of the Royal College of Physicians or Surgeons or in other disciplines. It is a long ladder to climb.

Furthermore, in order for a doctor to specialize he or she has to be in permanent post for at least 3 years in a specialized department of a government hospital (not private hospital which is not recognized) for teaching and training purposes, experience and exposure in that area the doctor is interested in. He or she will have to work under the supervision of a specialist or a consultant. So that is another ladder to climb.

 The doctor cannot afford to be a contract doctor with no permanent position and is posted here and there especially to a small hospital or in a rural area where he or she is a stand-alone doctor where every little complication needs to be referred or sent by ambulance elsewhere. He or she can never specialize in any field of medicine or surgery. He / she has to be in a big, tertiary or in a teaching hospital for teaching, experience and exposure purposes first.  

As far as your question on technicality and difficulty on diagnosis is concerned, straight away I should emphasize the diagnosis of malnutrition and nutritional disorders. This is the most difficult and most technically challenging branch of medicine for any doctor or even for an expert nutritionist.

First of all, the word “malnutrition” actually means “bad nutrition” to mean “mal” “bad,” “wrongful,” “ill,” from French word “malapert” such as we say “malpractice, malodorous, malformation, malformed, maladjustment, and so on.

Malnutrition does NOT mean only undernutrition as most people, including even specialist physicians think. It technically includes those who are also over-nourished with excessive nutrition from overeating. Overnutrition too is bad or malnutrition. Does that surprise you? I am more than sure you do, including all medical doctors who thinks that malnutrition means only those suffering from nutritional deficiency diseases such as marasmus, kwashiorkor, beriberi, pellagra, rickets and hypocalcaemia, osteomalacia, vitamin K deficiency, xerophthalmia, anaemia and iron deficiency...all the way down to over 350 different types of nutrition deficiency diseases.

 Unfortunately, most doctors are not familiar with them. They tend to misdiagnose them as something else and prescribe them chemical drugs instead.

For instance, a person who is underweight and always feels tired and lethargic should be a suspect of caloric undernutrition. This is because of the body’s innate response to converse energy rather than to lose body mass. So, he or she feels tired and lethargic most of the time to need rest. This has nothing to do with an under thyroid function and needs to do a thyroid function test with all those T3 T4 and all those unnecessary stuffs.

 On the extreme end, over nutrition is the root cause of most of the chronic and degenerative diseases such as cardiovascular, diabetes, endocrine and metabolic syndromes, gout, arthritis, renal, liver, cancers and neoplastic diseases. All these are mainly caused by malnutrition, either under or over nutrition afflicting mankind today due to affluence and overeating and lifestyles. None of these can be “cured” by any chemical drugs that only mask them into other emerging linked diseases. The only way is dietary and lifestyle modifications which is best treated by a dietician. As clinicians and nutritionists, we are very clear on this.

One of the most difficult challenges in diagnosing malnutrition for a doctor or for a nutritionist whether under or over nutrition is, that their presentations (clinical signs and symptoms and even blood tests) do not show up. Most of them are subclinical without signs and symptoms which would be riskier unlike a heart attack, a fever, pain, nausea, vomiting where tell-tales signs are very clear which we can differential diagnose by asking questions, looking for signs and symptoms, taking medical history, clinical examination, blood tests, radiology and imaging and so on. These are not the slightest problems to do or observe. But not with malnutrition which is a disease that can be fatal leading chronic and degeneration of all body systems if not corrected with dietary and lifestyle modification. None of these nutritional diseases, whether under or over nutritional, can be “cured” by prescribing all sorts of drugs, or rather chemicals. That is more than sure. That makes diagnosis, management and compliance extremely difficult for both the doctor and the patient.  

For instance, if you were to ask me if you are malnourished, meaning either undernourished or over nourished, I would not know. You may appear well-fed and healthy physically in appearance and none of any blood tests would show anything. They would all appear as negative with no abnormality shown unless I perform what we call a saturation  test (British) or loading test (American) on you to look at your water-soluble vitamin such as thiamine, riboflavin or ascorbic acid or Vitamin B₆, (nicotinamide) status where we dose you a certain amount of the water soluble vitamins and see how much is been retained by the body, and how much excreted into the urine.

A person may look perfectly well and healthy but in truth his / her health is below optimal, and optimal health depends so much on optimal nutrition. But what then is optimal health and optimal nutrition? The answer is, we do not know as it varies from individual to individual depending on his / her daily nutritional needs which again depends on gender, age, physical activities, physiological requirements, perhaps race, environmental temperatures, body weights among other internal and external influences such as lifestyles. These problems are very complicated to sort out, and we can only take an average from large population studies of apparently healthy people. That is the reason why every country has their recommended daily allowance for various nutrients according to age, sex, pregnant and nursing mothers, heights, weights, physical activities among other factors to be considered. There is no standard dose for any nutrients so unlike drugs which are standardized. This is the reason why the practice of nutrition is so much more complicated than the practice of medicine where the dose is almost fixed and easy to titrate.

In nutrition variations in physiological and biochemical needs are so wide that no one can give a definitive answer. That is why if you were to ask me if you are eating the optimal requirements for your needs, or for the prevention of any disease I would not be able to tell you with certainty even though I am a nutritionist and clinician. You may only look every fit, healthy and well-fed, but within you, lies latent dietary and lifestyle diseases like metabolic syndrome like diabetes, cardiovascular, stroke and even cancers awaiting you in the years ahead. On the other end of malnutrition (undernutrition) you may suffer subclinical kwashiorkor (protein malnutrition), marasmus (caloric deficiency), beriberi (thiamine deficiency), scurvy (vitamin C / ascorbic deficiency), signs such as sore throat, lesions of the lips and mucosa of the mouth, glossitis, conjunctivitis, seborrheic dermatitis, and normochromic-normocytic anaemia (riboflavin or B2 deficiency), iron deficiency  anaemia, together with vitamin B12 deficiency resulting in Addisonian and pernicious anaemias.

Other nutritional deficiency diseases to name a few are, pellagra (niacin or vitamin B3 deficiency causing delusions or mental confusion, diarrhoea, photo-sensitive dermatitis, angular stomatitis, cheilosis, lacrimation, photophobia, Casal collar…etc, etc without you realizing them.

Most of them may be sub-clinical and do not show up. You may feel well, fit and healthy, but in fact you are not. That makes diagnosis exceedingly difficult. They don't even show up on any blood and biochemical examination unless very serve where certain metabolites appear in the blood due to incomplete metabolisms where these vitamins are needed. One example is erythrocyte transketolase activity coefficient (ETKAC) assay for thiamine (vitamin B1) status.  

Else the assessment of nutritional status is exceedingly difficult even for large populations, let alone for individuals based only on clinical examination alone or some blood tests.

 Please see link below how the assessment of nutrition status is done by the coordinated efforts from a team of nutritional, medical and other health professionals.

In fact, the diagnosis of malnutrition is more difficult even for an expert well-qualified nutritionist let alone for a doctor who knows very little on nutrition unless the clinician specialises in nutrition at post graduate level with a master’s degree in this area.

When I was doing my postgraduate in nutrition at Queen Elizabeth College, University of London we were all retrained by the University on the procedures in assessing nutritional status and how to diagnose clinically cases of acute or sub nutritional diseases. There were a number of us in our postgraduate course. They came from various countries. We were all there at London as students, all medical doctors, plus one biochemist from the University of Manchester and a Master degree holder in pharmacology from St Andrews University, one doctor from the University of Singapore, and one Dr Jason ST Teoh from the Faculty of Medicine, University of Malaya, who later began the Head of the Department of Social and Preventive Medicine, and later became a  Professor and Dean of the  Faculty of Medicine at the  University of Malaya. Unfortunately, Professor ST Teoh has since passed away.

One was a gynaecologist from Oslo, Norway, one doctor from Canada, another from Nigeria, one from Hong Kong, the rest of the doctors from the UK itself.  We were very, very well trained, over and over again by London University on how to recognize, diagnose and also how to assess the nutritional status of a community using all means available to us, not just clinically, using blood or urine tests.

Just to give readers a glimpse how this is done, we need teamwork effort from other experts and specialists such as physicians, nutritionists, anthropologists, sociologists, behavioural scientists, statisticians, medical lab technologists, nurses, and general workers to work together, and not just the doctor or the nutritionist alone.

A nutritionist is a very well-qualified professional who underwent a 4-year degree broad-based training course in a good university. A medical course is just one year extra at 5 years. A student in nutrition too has to study all the basic medical sciences such as anatomy, biochemistry, physiology, pathology, microbiology, etc, plus basic medicine just like any medical student. He carries these subjects in great technical detail in the first 2 years before studying applied nutrition and their practices. 

Nutritionists like dieticians are licensed professionals with protected titles by law in Malaysia as in most countries. Not everyone in recent years can call themselves a nutritionist or a dietician. Both are protected professions, and they must be qualified and licensed for practice. A nutritionist can diagnose malnutrition whether under or over or assess nutritional status far more qualified and much more expertly than a medical doctor or a clinician or a physician who has to deal also with other diseases. Normally a medical doctor will refer cases of nutritional deficiency diseases or nutritional-related disorders to a nutritionist for assessment and diagnosis. 

A dietician prescribes the proper diet for a patient especially for all those with dietary and lifestyle diseases, but a doctor prescribes drugs instead that unfortunately do not cure any nutritional or lifestyle disease. That’s the difference between these two healthcare professionals. But drugs too are very lifesaving in a medical emergency, not to say they are not good.

In most cases especially for modern lifestyle and dietary diseases a very difficult change for proper nutrition is the only medicine but are we willing and compliant. 

"Let Food be thy Medicine" (Hippocrates), and NOT let medicine be thy food as pharmaceutical companies would promote. 

However, drugs too are useful, especially fast-acting ones in a medical emergency.

See my explanation on fast-acting emergency drugs that can be lifesaving here: 

 

https://scientificlogic.blogspot.com/search?q=emergency+drugs

 

Having briefly explained all that, should you insist in asking me again since both, sub-nutrition and overnutrition are mal or bad nutrition, and you insist of which between the devil and the deep blue sea would be the worse, I would say overeating and over nutrition is the greater devil since as far back as in1935 Clive McCay at Cornell University has clearly shown that food restriction especially caloric restriction prolongs life span. Subsequently, over 100 studies done on literally all animals showed the same, not just longevity, but disease-free longevity. I think there is a lot of gospel truth in all these findings since McCay’s time since overeating and over nourishment generates a lot of harmful metabolites, especially damaging free radicals the body, especially the liver and kidneys have to deal with, besides not giving a chance for any bowel and body system rest. It is like churching our food waste and garbage 24 hours a day for clearance with excessive food being thrown out into the streets as garbage.

Which would we choose, under or over nutrition since both are classified as bad or malnutrition  

"Mal" means "bad". 

Explaining further, let us give ourselves an example of normal distribution curve.

In a normal distribution curve there is a minmium on both sides, with a peak somewhere in the middle. The peak is the average or the medial where the cluster of the data is highest. Clustering around the medial are the rest of the data with its Standard Deviation at the tail ends of the the distribution curve. 

Assuming this peak represents the optimal nutrition which we may also represent as optimal health.

Anything on the left of the left of the curse is sub-optimal. Let this be undernutrition. 

Anything on the right of this peak is also sub-optimal, representing excessive and overnutrition. 

Anything on either side of this optimal (maximum) peak is either under or over optimal. Since we are unable to define or determine which would be under or over nutrition for an individual, which side of the curve would we choose to advise an individual how much he or she to take at least to get as close as possible to reach the peak of optimal health? Bear in mind all recommended nutrient intake is based on very large population studies who are in apparent good health through food consumption studies, clinical, anthropometric measurements, age, heights and weight, gender, occupation, physical activities, biochemical, social, economic studies, food supply and food balance sheets among other parameters.  Now we are in hot soup between the deep blue sea and the devil. We cannot answer this with certainty since our nutritional needs are so personal and individualized. We can only  rely on Recommended Daily Allowance based on food consumption studies in large population studies.

As a research nutritionist and food scientist I would not be able to give any specific advice to any individual on his specific nutritional requirements because of vast individual variations. 

This is so unlike the practice of medicine where we can prescribe  the exact dosage of a medicine to a patient. This make the practice of medicine far, far easier than the practice of nutrition for sure. The practice of medicine is quite standard plus or minus a little bit, but not in nutrition because of vast biological needs. 

But if you were to force me for an answer, I would choose the deep blue sea of undernutrition for the simple reason I have explained that there are now over 100 studies both in humans and all animals without exception that under nutrition, specifically caloric restriction greatly prolongs life, not just longevity but disease-free long life. 

I have already proposed a few logical theories to explain this. It is up to nutritionists, nutrition scientists,  and other biomedical scientists to accept these hypothesis and use them as a springboard to work on them further. 

Under nutrition in very severe cases only such as marasmus, kwashiorkor, scurvy, night blindness, beriberi, riboflavin deficiency, pellagra, iron deficiencies...etc, etc can easily be corrected within days, but not chronic degenerative diseases such as diabetes, metabolic syndrome, cardiovascular and stroke, renal, liver diseases due to overnutrition. 

So make your choice between the deep blue sea which can be rescued and the devil that is permanently taken away 

This is just one of the reasons. But I think if we look at this from the evolutionary perspective it is just the way Nature wants any living animal, us included, to adapt to drastic changes in food supply and in harsh environments so that we can become hardier and able to survive with minimum nutritional needs. In a nutshell, the body conserves energy without sacrificing its body mass loss due to caloric restriction to thrive better and longer disease-free. It just merely obeys the biological laws of “survival of the fittest” by being more adaptable to changes in nutritional needs with lesser calories available by being less physically active in order not to lose body mass (body weight) so that it can survive longer.

This theory of mine why we may live not just longer, but with disease-free longevity is just an extension of Herbert Spencer concept he proposed in 1852 after reading Charles Darwin's On the Origin of Species – in his Principles of Biology published in 1864. Evolutionary biology, an area of study coincidentally I happened to be familiar with at Cambridge. 

I think the best analogy to explain this is like a lamp with very little fuel. The lamp will adjust itself conservatively by demanding very little fuel. It will then burn with a very low flame, a slow dim glow for a very long time till the fuel runs out naturally.  But if we start to pour a lot of oil over the lamp, it will suddenly burst into a big fire that will not last very long as the fuel burns itself out fiercely.  In fact, the big fire will destroy the entire lamp and burn it down instead. Likewise, with caloric (energy) restriction, the metabolic rate slows down with less metabolic wastes generated, the body becomes physically less active, and its lifespan is prolonged. 

Vegans and Life Expectancy:

Similarly, I believe if vegans too restrict their plant-based consumption with lower caloric content they too would have longer spans together with the protective effects of antioxidants and thousands of phytochemicals in them. Although the studies on the longevity of vegans are mixed and limited, we cannot refute the belief they would live a longer disease-free life if they do not compensate for their low-caloric diet with greater amount of food intake. But I think vegans do overeat in their belief that: 

"If a little does me good, a lot will do me even better"?

 I am not sure. Perhaps vegans can tell me better! 

  

The lengthy and laborious job of conducting an assessment of nutritional status is summarized in this link below.

https://scientificlogic.blogspot.com/2023/05/the-assessment-of-nutritional-status-in.html

We can see in the study above, how elaborate it is, as it involves so many medical and scientific experts with their expertise working together, not just the doctor or the nutritionist alone.  It is not just the case of just taking medical history, doing some clinical examination, conducting some blood, urine, serological tests, microbiological assays, radiological examination, HPE (biopsies) only, and just prescribing some medicine. It is far, far more and complicated than that.   

 

I hope I have answered your questions and have explained. Nutritionists too are very highly paid. I personally know many of them work as Senior Consultants and in managerial positions in drug, health companies, clinical or analytical laboratories with over RM 18,000 per month salary, or in private practice or teaching in universities as professors or as Dean of a medical faculty like my course mate, the late Professor ST Teoh or Professor Sim my former course mate one year ahead of me in London, who then became a professor at the University of Singapore.

 I myself was offered a WHO job in cancer research at Lyon, France which I declined, and was offered to work at the Massachusetts Institute of Technology (MIT) as a medical and food toxicologist, and later was offered a permanent senior position with the Ministry of Health at the Institute for Medical Research in Kuala Lumpur as a Senior Medical Research Officer and Deputy Head of Rural Health and Community Medicine. Of course, I am now happily retired.

 

So, Mrs Shanzey, the scope in all fields of medicine and health care is very wide, all with good income. Ask your doctor daughter to make her own choice, except in emergency and forensic medicine if she intends private practice later. Emergency medicine, pathology and forensic medicine are only for those who were offered permanent and pensionable jobs with the government. They are a failure and wash out if in private practice.

Regards

Lim ju boo.   

 

 

More articles by this authour

 

Further articles by this author can be found in Ir. TO Lau blog here:

https://taionn.blogspot.com/search?q=lim+ju+boo

Water Pressure at Seabed where the Titanic sank and Titan Imploded

 

The sinking of the Titanic remains one of the most famous maritime disasters in history and has captured public interest and attention for over a hundred years.

The RMS Titanic was a British passenger liner that embarked on its maiden voyage from England on April 10, 1912, bound for New York City in the United States. It made brief stops at Cherbourg, France, and Queenstown (now known as Cobh), Ireland, to pick up additional passengers.

Shortly before midnight on April 14th, 1912, the Titanic, at the time the world’s largest passenger ship, struck an iceberg, and a few hours later completely sank in the icy waters of the Northern Atlantic Ocean.

There were 2,224 passengers on board the ship, of which around 1,500 died after striking the iceberg.

The most famous shipwreck

The wreckage of the Titanic was discovered on September 1, 1985, by a joint French-American expedition led by Jean-Louis Michel of IFREMER (French Research Institute for Exploitation of the Sea) and Dr. Robert Ballard of the Woods Hole Oceanographic Institution. The shipwreck lies at a depth of about 12,500 feet (3,800 meters) on the ocean floor.

Since its discovery, salvagers and researchers have dived to the depth of 12,500 feet (38100 metres / 3.81 km) where the remains of the Titanic are located. It's final resting place is almost 600km off the coast of Newfoundland, Canada in the North Atlantic Ocean.15 

It is the at the same site and depth as the deep-sea submersible carrying five people on a voyage to the century-old wreck of the Titanic was found in pieces from a “catastrophic implosion” that killed everyone aboard, the US Coast Guard said yesterday, ending a multinational five-day search for the vessel.

https://www.malaymail.com/news/world/2023/06/23/titanic-sub-destroyed-in-catastrophic-implosion-all-five-aboard-dead/75843

This give me an idea what was the seabed pressure at the depth where the deep-sea tourist submersible imploded?

Let’s check this out:

Density of seawater is between 1.02 and 1.03 g/cm³ (1.025 g /cm³) or 1026 kg / cubic metres.

Hence the water pressure where both the titanic sank and the deep- seas tourist submersible imploded was:

P = ρ g h

Where,

• P = water pressure in Pa
• ρ = density of water in kg.m^-3
• g = gravitational force in 9.81 m.s^-2
• h = height in m

= 383,478,786 Pa or approximately 383,479,000 Newton per square metre

= 39,104,099 kilograms per square meter

(1 pascal × 0.101972 = kg m3)

The atmospheric pressure at sea level is 30 inches of mercury (Hg)

= 760 mm Hg  

=1013.25 millibars

= 10,332 kg per square meter

This means that water pressure at the bottom of the of the ocean floor where the Titanic sank, and the tourist Titan submersible imploded is whopping 3,785 times greater than the atmospheric pressure here on our surface. It is little wonder why the Titan submersible would not be crushed inside under such tremendous water pressure?

Suppose this Earth turns into a black hole (it will never) unless its mass is 3 – 5 times that of the Sun, then this Earth will collapse to the size measuring:

 Rs = 2GM / c^2

= 2. x 6.6738×10⁻¹¹ m³⋅kg⁻¹⋅s⁻² x 5.972 × 10^24 kg / (299792458 m⋅s⁻¹)² 

= 8.869 x 10 ^-3 meters (0.008869 m)

= 0.887 cm in radius or 1.8 cm in diameter which is slightly less than half the size of a ping pong ball

It  would exert a pressure of 5.972 × 10^24 kg / 4 pi r^2

= 5.972 × 10^24 kg / 4 pi (8.869 x 10 ^-3 meters) ^2

=5.972 × 10^24 kg /9.8846 ^-4  

= 6 x 10 ^27 kg per sq. metre

where,

Mass of Earth is 5.972 × 10^24 kg.

G = gravitational constant (6.6738×10⁻¹¹ m³⋅kg⁻¹⋅s⁻² 

C = speed of light in a vacuum (299792458 m⋅s⁻¹)² 

The black hole of Earth would be 1.5 x 10^20 (15,0 000 000 trillion times) greater than the water pressure at the bottom of the seabed where the Titanic sank.

 (Surface area of the sphere = 4 pi r ^2, where “r” is the sphere's radius)

Just a sober thought for the souls who died in the Titanic and Titan tragedy.

Further articles by this author can be found in Ir. TO Lau blog here:

https://taionn.blogspot.com/search?q=lim+ju+boo

Do We Actually Live inside A Black Hole?

 

Do we actually live inside a Black Hole as postulated by the world renown Dr. Michio Kaku PhD, an American theoretical physicist, activist, futurologist, and popular science writer. He is a professor of theoretical physics who claimed that the entire universe is a black hole, and we live inside this blackhole? This means to me the black hole we live in must have a super light density, because we know that black holes are so massive, and its gravitational pull so unspeakably powerful that nothing can get out once pulled inside.  

His claim was sent to me by my brother-in-law Ong Geok Soo, a Senior Consultant Structural Engineer in a video here:

https://www.youtube.com/watch?v=a2x3QpP5t2s

I wrote an article published on Sunday, May 21, 2023, to prove that even light cannot escape from a black hole here:

“On Astronomy and on Light Trapped inside A Black Hole”

https://scientificlogic.blogspot.com/2023/05/why-is-light-trapped-inside-black-hole.html

https://scientificlogic.blogspot.com/search?q=black+hole

Dr. Michio Kaku claims that recent discoveries by the James Webb Space Telescope have shown that we live inside a black hole?  

Since I do not have access to the James Webb Space Telescope or any data, not even indirect data from any telescope, let alone the James Webb Space Telescope, I decided to do my own simple calculations to find out how could this be?

Let’s check this out:

The radius of a black hole called the Schwarzschild radius is the event horizon surrounding a non-rotating black hole. Any object with a physical radius smaller than its Schwarzschild radius will be a black hole. This quantity was first derived by Karl Schwarzschild in 1916:

The radius of this black hole is given by:

Rs = 2GM / c²

where,

G is the gravitational constant (6.6743 ± 0.00015) × 10⁻¹¹ m³ kg⁻¹ s⁻².

M is the mass of the Universe (10 ⁵³ kg)

Speed of light 299 792 458 m / s

Hence Schwarzschild radius of the universe if it was a black hole = 1.49 x 10 ²⁶ meters

Volume of the black hole is:

= 4/3 pi r ³

= 4/3 pi. (1.49 x 10 ²⁶ meters)³

= 1.39 x 10 ⁷⁹ m ³

Density of the universe if it was a black hole:

 Mass of the black hole universe / volume of the black hole  

= 10 ⁵³ kg / 1.39 x 10 ⁷⁹ meters

= 7.19 x 10 ^{– 27} kg m ³

Wow! What a revelation to me!  

The black hole in which we live actually has a super-super light density at only:  

0.00 000 000 000 000 000 000 000 000 719 kg per cubic metre.

No wonder we can all live and move and fly about so freely as if it was a vacuum except for the thin air we breathe even though we live inside a super black hole.  

If we lived inside a super-super massive black hole, I expected the entire world would be crushed into the size of a neutron 0.000000000000001 m (a thousand trillionths of a meter) in diameter.

But we are alive here with our imposing Warisan Merdeka Tower in Kuala Lumpur still rising to 678.9 metres high and we have not been crushed by the black hole to the atomic size of a hydrogen atom 0.00000000037nm (3.7 x 10 ^-19 metre). We can also see light from the Sun and stars coming in and escaping into space. What a wonderful we live in.  

 Wow! What a revelation!  Is this a dream? It is too fantastic for me to accept.

I hope Dr. Michio Kaku PhD is right, and I am right too?

 Dr. Michio Kaku uses highly sophisticated astrophysical mathematics plus findings from the James Webb Space Telescope to derive, but unfortunately, I only have simple physics at my disposal.

Thank you, Dr Kaku.

Jb lim  

Is Milk Intolerance Genetical? A Question was Asked by a Reader. Can We Solve this Nutritional Problem?

 

 

A question was asked in the comment column under this article:

“Why Most People Cannot Tolerate Drinking Milk” in this link:

https://scientificlogic.blogspot.com/2023/

It reads:

“Very interesting explanation. My eldest brother who is 41 years old, 15 years older than me, can tolerate drinking milk, but not myself. He has been drinking milk regularly since he was young without problem, but not myself. I get severe diarrhea if I do.  We are both from the same parents. So, there should not be any genetic difference. Why then is this difference in tolerance and health problems?  Maybe you have the answer?

Sussie Chan”

……………………………………………………….

My answer to Sussie:

Thank you, Suzzie for your comment and question in my article “Why Most People Cannot Tolerate Drinking Milk”?

Before answering your question, let me explain just a little bit about genetics, and environmental influence on genes. Just a bit will do together with other ‘irrelevant’ information if you don’t mind so that we can understand nutrition better. Nutrition is far, far more than just what food to take, what food to avoid or what foods are health-protective, others disease causing. 

The study of nutrition is a hectic formal 4-year degree course involving almost the entire spectrum of biological, biomedical sciences,   chemistry, biochemistry, chemical analysis of foods statistical analysis, sociology, agriculture and food production, soil science, behavioural science, clinical medicine, especially in the diagnosis and recognition of nutrition and nutrition-related diseases, These were subjects in our formal intensive training during our postgraduate study at least at the University of London. But I have little idea about other universities what they were taught there?  The study of nutrition is done from bachelor’s to master’s levels, onwards to doctoral and well past doctoral levels. So, what I shall explain here is only a teeny-teeny tiny glimpse of it so that we can answer your question better.  

Although there is genetic similarity between you and your brother, bear in mind genes do influence social behaviour besides the types of proteins it expresses. Each cell expresses, or turns on, only a fraction of its genes at any given time. The rest of the genes are repressed or turned off. The process of turning genes on and off is known as gene regulation. Gene regulation is an important part of normal development. Genes are turned on and off in different patterns during development to make a brain cell look and act different from a liver cell or a muscle cell, as examples. Gene regulation also allows cells to react quickly to changes in their environments. Although we know that the regulation of genes is critical for life, this complex process is not yet fully understood.

Gene regulation can occur at any point during gene expression, but most commonly occurs at the level of transcription (when the information in a gene’s DNA is passed to mRNA). Signals from the environment or from other cells activate proteins called transcription factors. These proteins bind to regulatory regions of a gene and increase or decrease the level of transcription. By controlling the level of transcription, this process can determine when and how much protein product is made by a gene.

Lactase deficiency is believed to be genetically programmed to produce this protein enzyme lactase that breaks down milk sugar lactose into lactic acid and other products.  Its ability to do this is age-related as the LCT gene responsible for the production of lactase becomes progressively latent with time. According to some studies LCT genes remain active between the ages of 5-20 years.

It was once thought that genes do not change. But recent research in the field of epigenetic showed that genes do change in response to the environment, and they are capable of changing their cellular behaviour including the social behaviour of the individual.  It is the case of nature vs nurture. In fact, it is their ability to change especially to the environment as a stimulus that is the very reason how all living organisms begin to adapt for the better. This is not something new as we think.

As far back as in 1864 Herbert Spencer in his “The Principles of Biology” looked at Darwin’s evolution as “Function, Adaptation and Variation” of the various species of life where he introduced the expression 'survival of the fittest', in the sense of 'the most appropriate to its environment'. Scientists have only recognized this behaviour and adaptive changes only recently, and they gave it the name of this new study called ‘epigenetics’.

Epigenetics is the study of the environment and its impact on behaviour, and how the changing environment affects the way the genes are going to express themselves. Gene expression means the process by which the information encoded in a gene is turned into a function. This mostly occurs via the transcription of RNA molecules that code for proteins or non-coding RNA molecules that serve other functions.

Unlike genetic changes, epigenetic changes are reversible and do not change the DNA sequence, but they can change how the body reads a DNA sequence.

Another way of explaining this is, the environment influences the behaviour of our genes and how they work for us, even though the environment does not change the DNA sequence, but they can change how the body reads a DNA sequence to change the way we behave and react.

For example, a pair of identical twins born from birth but brought up separately in different environments and social influences may have entirely different social characteristics and behaviour though their physical features remain identical.

In the same way we may explain why two identical twins or as in your brother case, and yourself as a sister, your brother is drinking milk persistently till age of 41, and he becomes milk tolerant, whereas with yourself who does not, becomes intolerable to milk and lactose. This may be due to adaptation when your brother is constantly exposed to the same dietary environment that induces the LCT gene that produces lactase to remain active lifelong, whereas for others like yourself where milk was switched off in favour of other foods, has caused the lactase-producing genes to switch off when no longer stimulated or needed.

Hence, it is not surprising to me that your eldest brother, though has genes similar to yours, has adapted for the better by stimulating his genes to adapt to milk drinking since a baby till he is now 41 years, whereas your similar parental genes have not. I suppose your parents may have traditionally been feeding him milk since a baby 15 years earlier than yourself since social behaviour does change over just one generation from past traditions to recent trends, and that could have affected the genes to continue to express the enzyme lactase to break down the lactose in milk.

This is precisely what I mentioned earlier in my article on milk intolerance that milk (milk sugar lactose) affects mainly the Asians, predominately the Chinese whose mothers took off their babies from milk far too early after one year instead of allowing them to continue with milk as a supplementary food after weaning them to other foods. The problem about nutrition is, it is such a complex mixture of scientific-medical-social-economic-behavioral-anthropological field of study that we know so little about their interactions, such as what food is exactly right for us, or when to switch over from milk to other foods. We must bear in mind milk like eggs for a developing chicken that is still incubating inside the eggs for 21 days is the only food for the chick, as with milk as the only complete food for all mammalian babies including human babies.  

In fact, nutritionists recommend that a baby should be given other foods as early as 6 months, although they did not actually suggest that milk should not be given after 6 months. In other words, the nursing period of 6 months does not necessarily mean that milk should not be drunk after that, bearing in mind milk is still the complete food rich in all nutrients that could support the growth of a body till even well past one year, not just for 6 months as nutritionists recommend. I have seen children drinking milk even at 5 years old and they look very healthy and active. Perhaps milk may not have sufficient calories to support the energy requirements of a growing child. Milk is so good and complete in nutrients that calves that are much heavier and stronger than human babies feed on them from mother cows till it becomes almost an adult cow, buffalo or a bull. These animals, as with all other mammals that feed their young till they can thrive on their own food, have no problem with milk or lactose intolerance, only humans. I suppose our busy commercial and economic lifestyles are such that we have no patience in breastfeeding or to continue to bottle-feed our babies as long as they want the milk.

Human milk contains 3%--5% fat, 0.8%--0.9% protein, 6.9%--7.2% carbohydrate calculated as lactose, and 0.2% mineral constituents expressed as ash. Its energy content is 60--75 kcal/100 ml.

The energy requirement of a child from 1 - 5-year-old is generally 100cal/kg/day between 1 to 3 years old, 80 kcal/kg/day, between 4 to 5 years, and 70 kcal/kg/day, 6 to 8 years needs 60 to 65 kcal/kg/day from 6 to 8 years, and for 9+ years he / she needs between 35 to 45 kcal/kg/day. Our problem is that food is like medicine. We know a lot of things in medicine, but surprisingly a lot of information on nutrition remains unknown to us. So, milk alone may not be sufficient in quantity to support accelerated growth in a child, and other foods need to be supplemented after 6 months of weaning.

In medicine, drugs are used, and we know a tremendous lot how they react in the body (pharmacodynamics) and how the body deals with them (pharmacokinetics) because all drugs are just pure organic compounds, mostly synthetic, and we can easily trace their pathways in the body – how they are metabolized and excreted from the body. But with food as a medicine, especially plant-based, they contain tens of thousands if not millions of phytochemicals and medicinal values, not just nutritional values in them. 

Furthermore, if they are eaten in a wide variety, how are nutritionists and nutritional scientists going to know how they are going to react in the body, let alone their phytochemicals reacting and cross-acting with each other on ingestion?  It is almost impossible to know or to trace their metabolic pathways.  That is the reason we often receive all kinds of unsubstantiated health, often contradictory health-protective, or health-damaging claims about foods in videos, WhatsApp, advertisements, health magazines, newspapers and in social media. Everyone is taking advantage of our ignorance.  

Nutritionists now call foods that have other nutritive or medicinal functions as “functional foods” defined as foods that contain, in addition to nutrients, other components that may be beneficial to health or have a potentially positive effect on health or their medicinal therapeutic values beyond basic nutrition.

Traditional standard food composition tables give us the nutritive valves of the major food chemical components – carbohydrates, proteins, fats, vitamins, and minerals. Some food tables provide us values of trace minerals as well. But none of the food composition tables tell us anything about “non-nutritive” substances, yet health-protective principles in them – the tens of thousands of naturally-occurring phytochemicals and their protective or medical properties bestowed by Nature for us as medicines as well. It is almost impossible for any analytical food scientist to analyse them all, let alone for nutritionists to study their health impacts on the body.

The National Institutes of Health (NIH) is the largest funder on health issues, with nutrition research investments estimated at $1.9 billion annually (5% of total NIH funding) for fiscal year 2019. Approximately 25% of this funding (1.3% of total NIH funding) focuses on diet for the prevention or treatment of disease in humans, and yet we know so little about how food can affect the body and health. This is only in America. World-wide nutrition research takes precedence over all other medical research. World-wide it is estimated the annual expenditure spent on nutrition research exceeds US 100 billion dollars resulting in an avalanche of research papers published with a bit of inroads made on how food affects our health and on  latency of diseases yet to come, yet we still know only a little. Nutrition for health is probably the most favourite and popular subject ever written very often in women and man magazines, and widely  discussed in all print and electronic media including on television and on radio, including messages and information circulated in WhatsApp chat groups.  

Only cancer research at US$2.9 billion in 2020 exceeded that of nutrition research. Previously it was nutrition and nutrition research that occupied the central stage in health care. These are the only two areas, cancer and nutrition research that are given the highest priorities in medical research and yet we cannot completely solve problems on disease under these two fields. Let’s take just these two examples: nutrition and medicine.    

In medicine for instance, we know the dosage of the drug to give. We can titrate the dose to the patient’s needs. We can adjust it to a person's body weight up to the maximum dose allowed according to the drug manufacturer’s instructions.

But with food it is so complicated that we only have some idea how much nutrient intake to recommend, but not give to an average person. Nutritionists call this as “Recommended Daily Allowances (RDA).  We can only recommend a certain plus and minus allowance because we do not know exactly how much intake is needed for each nutrient for optimal health. It varies so much for individuals according to their age, sex, physical activities, childbearing or not, genetic make-up (ethnicities), body size and weight and even their health status.

Even for health we cannot give any specific or single definition.  W.H.O. in its Constitution gave a very broad holistic definition of health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” That definition does not even tell us or explain what then “optimal health” is?   

Thus, the recommended daily allowance for food intake is based on numerous studies done on as huge a population who are in apparently good health, and the average taken based on so many influencing factors such as age, sex, morbidity and mortality, food consumption, types of foods and quantities consumed, metabolic activities, active and sedentary lifestyles, disease patterns, and so on. These recommendations are not even fixed. In most countries they are revised every 5 years by a huge committee of highly powered medical and nutrition experts because nobody knows the precise “dosage” for nutrient requirements, unlike we do for drugs.   

The RDA is the average daily dietary intake level that is sufficient to meet the nutrient requirement of nearly all (97 to 98 percent) healthy individuals in a particular life-stage and gender group. The RDA is the goal for usual intake by an individual.

The RDA depends not only on age, gender, physical activities, but also on environment temperatures, food availability, social, cultural, personal, psychological, economic factors, let alone state of health, beliefs, food taboos among others. It is a highly, highly complicated problem so unlike in medicine where problems on disease, drugs indicated, and dosages are so clear cut to us.

Coming back to the nutritional problem, what strategy can we implement to solve, if not reverse lactose and milk intolerance.  Perhaps one answer is, we can use lactose-breaking bacteria found in the colon (beneficial human microbiota – the colonic microbiome) that has endogenous lactase activity,

These bacteria can break down lactose (milk sugar) into lactic acid. Some of these lactose-bacteria called Lactobacillus and Bifidobacterium, especially Lactobacillus bulgaricus and Streptococcus thermophilus are also found in yoghurt. They possess beta-galactosidase activity (bacterial lactase) that allows them to digest and utilize lactose. These bacteria hydrolyse the lactose to glucose and galactose and subsequently ferment them to lactate, short-chain fatty acids (SCFAs), and gases, such as H₂, CO₂, and CH₄ Although Bifidobacterium bifidum expresses lactase activity, no clinical trials have determined its impact on lactose-intolerant subjects.  

Unfortunately, in normolactasia (normal lactate), when intestinal lactase is high, only a small percentage of ingested lactose reaches the colon.

Lactose cannot be directly absorbed in the intestinal tract and must, instead, be broken down into its two smaller component sugars by an enzyme called lactase and hence they cause intestinal disturbances if they stay there unbroken down and unabsorbed.  Normally, the activity of the LCT gene that produces lactase, LCT, declines after infancy. Recent evidence suggests that a decline occurs not because the genetic code is changed, but because the DNA is chemically modified so that the lactase gene is switched off due to shut down of dietary influence. The epigenetic modification that turns off the lactase gene does not happen in lactose-tolerant individuals like your brother who constantly drinks milk. This observation is crucial in understanding how lactose intolerance develops with age.

Recent studies have shown that the symptoms of lactose intolerance can be alleviated in some people by changing the population of their intestinal microbiome by transferring lactose-digesting bacteria such as yogurt in them. The adaptation of the intestinal microbiome may explain why some ancient pastoral populations with no genetic evidence of lactase persistence tolerated milk and dairy products.

We think that giving lactic acid bacteria such as yogurt and fermented products regularly as a probiotic can ease the symptoms of lactose intolerance, because these bacteria may not persist in the colon. One promising new strategy is to give the lactic acid bacteria a complex sugar that they can digest but humans cannot for them to remain in the colon. But this needs to be studied.

Another way I can think of, is to use faecal microbiota transplantation (FMT) where a solution of faecal matter from a milk-tolerant donor is introduced into the intestinal tract of a non-milk tolerant recipient in order to directly change the recipient’s gut microbial composition to confer a health benefit to someone who is milk intolerant. That may be another good nutritional strategy we can work on.  

In summary, lactase deficiency is thought to be genetically programmed and age-related as the gene that is responsible for the production of lactase (LCT gene), becomes dormant progressively with time. It tends to appear between the ages of 5-20 years and may be prevented through epigenetic influence by regularly drinking milk.

As a last note, let me tell you that I too am milk intolerant if milk is drunk more than 500 ml in one sitting. Perhaps my ICT gene is still active by putting milk regularly in smaller quantities into my tea, coffee, and cocoa-based beverages, though slowed down and the lactase expressed is insufficient to deal with more than 25 g of lactose in 500 ml of pure milk if drunk in one go.     

I hope I have explained to you Sussie Chan

(A 3,297 worded answer in 10 pages)